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For National Hispanic Heritage Month, Dr. Helen Rodríguez Trías

Kathryn S Gardiner | Published on 9/10/2023

Forgotten Foremothers

Profiles of lesser-known heroines in the fight for women’s rights

Dr. Helen Rodríguez Trías

In 1973, social workers in Montgomery, Ala., expressed concern to Minnie Relf, the mother of sisters Minnie Lee and Mary Alice. The sisters, both impacted by learning disabilities, were 12 and 14 at the time. Boys were “hanging around,” the social workers said, so they took mother and daughters to a hospital for the contraceptive shots they’d received before. Mother Minnie, who could not read or write, signed a consent form with an ‘X.’

Minnie was shocked when she later saw her daughters in hospital gowns, and in pain. Instead of receiving shots, Minnie Lee and Mary Alice had both been sterilized by tubal ligation.

The Southern Poverty Law Center filed a lawsuit representing the Relf family. According to the SPLC, the investigation “exposed the widespread sterilization abuse funded by the federal government and practiced for decades.”
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Helen Rodríguez Trías was born on July 7, 1929, in New York City. Her family lived in Puerto Rico for most of her youth before moving back to the city when Helen was about 10 years old. As a Puerto Rican child in New York, she experienced a new sort of racism. “We were really struggling,” she said in an interview with the American Journal of Public Health in 2001. “My mother was not able to get a teacher’s license in New York, as bilingualism was considered a handicap. She took in boarders to pay the rent.”

In school, Helen found herself in an under-performing class. She had good grades and spoke English well, but children with surnames like Helen’s were not expected to excel. “When I graduated from sixth grade, I ended up in a class considered to be of the poor students,” she said. “One day I was called upon to recite a poem, and I knew the poem by heart. The teacher said, ‘Why are you in this class?' She moved me to the class with the bright kids. ... In Puerto Rico, racism was subtle, there wasn't the kind of separatist racism like in the U.S. I wasn't used to this.”

That teacher’s singular intervention was crucial. “I might have just as well gone down the tubes academically if that teacher hadn’t moved me out of that class. This is an example of how pivotal teachers are,” she said. “So many children are misplaced, tracked, or put in environments that don’t foster learning.” Growing up, she felt keenly the inequities around her, especially in the limitations forced on her mother, her aunts, and her sisters by their sex. She saw the “many restraints in their struggle to flower and realize their full potential.”

In 1948, at age 19, Helen enrolled at University of Puerto Rico in San Juan, with her eye on a medical career. Medicine, she said, “combined the things I loved most, science and people.” Her track through college was not a short or easy one. That same year, Law 53 passed in the Puerto Rican legislature, an act that criminalized owning or displaying a Puerto Rican flag, expressing support for independence, or even singing a patriotic song. Helen joined some 6,000 other students in a strike to protest the university’s decision to block a speaker who promoted Puerto Rican independence. The campus remained closed for nearly 2 months.

Helen’s brother had been helping her pay for college, but “if I were in a political movement, he would no longer help me.” So, she left school and returned to New York. She married lawyer David Neumark Brainin on Jan. 22, 1949. The couple had three children—JoEllen, Laura, and David—before divorcing in 1954. She remarried later that year to Puerto Rican writer Eliezer Curet.

Helen soon returned to her medical studies in San Juan, landing right in the heart of another political churn. Before the 1973 Roe V. Wade ruling, U.S. American women, like Rowena Gurner of the Army of Three, crossed the ocean to terminate their unwanted pregnancies. Helen’s interactions with patients and other medical students drew her attention to a desperate need. “I saw that anybody who could afford an abortion could get a perfectly fine one,” she recalled. “It would be written up as an appendectomy. Women from the U.S. used to go the Havana to get abortions. ... San Juan became the point where women converged.”

But these U.S. visitors were largely people of some means, who could afford the travel, lodgings, the procedure itself, and the return home. “If a poor woman needed an abortion,” on the other hand, Helen noted, “she came to the University Hospital in the middle of the night and said she had fallen and was having a miscarriage.” Many of these patients bore injuries or illness from homespun abortion attempts. During her internship, Helen witnessed a mother who had five children waiting for her at home die from a botched abortion procedure.

Her personal life brought its own painful lessons as well. Her divorce from Eliezar in Puerto Rico proved to be a “watershed in my life,” she said, referring to their union as a “deceptive marriage.” “That triggered quite a bit of growth in me toward understanding what happens internally to people, what happens in their lives and what they can do or not do.”

Helen caring for an infant in Puerto Rico, ca. 1963. Photo credit: Library of Congress, Prints and Photographs Division, photograph by Jim Hansen for Look magazine

At age 31 in 1960, she graduated from medical school. She finished her residency at San Juan’s University Hospital, then began teaching there. The National Park Service reports, “She also established Puerto Rico’s first infant health clinic. The results of her work were immediate: within three years, infant mortality at the hospital had declined by fifty percent.” When she returned to New York in 1970, she joined the Lincoln Hospital of the South Bronx as the director of pediatrics. She also continued teaching as an associate professor at a few nearby universities.

That same year, Helen became an active member of the women’s movement. She told the American Journal of Public Health in 2001, “What brought me to the women’s movement was the women’s health movement. The cultural elements of feminism didn’t resonate with me, but abortion resonated with me.”

The focus on abortion pulled her attention to the issue of reproductive rights as a whole. “The specialty of obstetrics-gynecology created folks very geared toward surgical solutions. This was one reason why cesarean section rates were going up. This didn’t necessarily respect women’s wishes regarding childbearing or other issues,” she said.

Reproductive freedom was especially fraught territory for childbearing Puerto Ricans. San Juan physicians had begun suggesting sterilization to some of their patients (often failing to inform the patient that the procedure was permanent) in the 1930s, and the practice spread. According to “The Role of Sterilization in Controlling Puerto Rican Fertility,” a 1969 article by University of Maryland sociologist Harriet B. Presser, “In the late 1940's (1947-48) an island-wide study revealed that about 7 percent of women had been sterilized. Another island-wide study conducted only six years later (I953-54) revealed that the figure had increased to over 16 percent of the women.”

In the United States, “State-sanctioned sterilizations reached their peak in the 1930s and 1940s but continued and, in some states, rose during the 1950s and 1960s,” wrote Dr. Alexandra Stern, a professor at the University of Michigan. “[I]n the 1960s and 1970s, new federal programs like Medicaid also started funding nonconsensual sterilizations. More than 100,000 Black, Latino and Indigenous women were affected.”

Many times patients consented to one medical procedure only to receive a second, like Fannie Lou Hamer who went into surgery for tumor removal in 1962 and received a “Mississippi appendectomy” (her slang term for a non-consensual hysterectomy) as well. Some patients had uteruses removed, others, like the Relf sisters, had their fallopian tubes tied or severed, all without their knowledge.

According to the National Women’s Health Network, “By 1965, one-third of all Puerto Rican mothers aged 20-49 were sterilized.” In addition, writes Julissa Arce for Unidos US, “Evidence showed that Spanish-speaking women were repeatedly approached during childbirth and pressured to sign consent forms written in English.”

In 1974, Helen helped found the Committee Against Sterilization Abuse and then the Committee for Abortion Rights and Against Sterilization Abuse. Colleague Susan E. Davis, who worked alongside Helen in the committee in the late 1970s, said in 2001, “If anyone deserves the title of mother of the movement for reproductive rights, it’s Helen Rodríguez Trías.”

Helen speaking at an abortion rights rally in the 1970s. Photo Credit: JoEllen Brainin-Rodriguez M.D.

The SPLC’s suit on behalf of the Relf family gave wider statistics and evidence to support what Helen and her fellow committee members already knew. “The case went to federal court, which said there was incontrovertible evidence that sterilization abuse was taking place, that some sterilization abuse was being subsidized by the government,” she said.

Helen’s committee continually pushed this issue, as well as abortion rights. They presented the story of the Relf sisters at meetings and before health boards. The strongest opposition they received was often from cisgender white women. Just as Helen had observed with abortion access in San Juan, race and class differences could exile women from one another.

When white women sought out tubal ligation and hysterectomies for permanent birth control methods or conditions such as cancer or endometriosis, they were often rejected for being unmarried or for not—in the doctor’s opinion—having had enough children yet. “They therefore opposed a waiting period or any other regulation that they interpreted as limiting access,” Helen explained. “While young white middle class women were denied their requests for sterilization, low-income women of certain ethnicity were misled or coerced into them.”

These experiences were crucial for Helen. Going forward, she understood the importance of having diverse viewpoints and actively sought them out. “I began to understand that we were coming to different conclusions because we were living different realities,” she told the American Journal of Public Health. “The women’s movement has been successful only to the extent that it shares experience, finds common ground, and fights for the same thing. ... We had to listen to each other; we had to find out each other’s reality. For example, I had a professional salary. I didn’t know what it’s like to live on welfare.”

Helen joined the American Public Health Association in 1972, expanding her mission to not only serving individuals but pushing for changes in policy, law, and government that impact people’s daily lives. “Public health is really about people’s life conditions and how these conditions do or do not promote health,” she said in 2001. “We cannot achieve a healthier us without achieving a healthier, more equitable health care system, and ultimately, a more equitable society.” She would later become with APHA’s first Latina president. “We still have a system that excludes, underserves, and even misserves all too many people.”

In the 1980s, Helen became medical director of the Department of Health AIDS Institute in New York, working primarily with HIV-positive women and children. The following decade, Helen joined the Pacific Institute for Women's Health as co-director. She also helped found the Women's Caucus and the Hispanic Caucus of the APHA. She traveled as far afield as Egypt and China to speak at conferences and advocate for women’s health.

On Jan. 8, 2001, Helen received a Presidential Citizens Medal from President Bill Clinton for her “unwavering conviction,” as she “challenged discriminatory practices in health care, encouraged community involvement in creating healthy environments, worked to prevent the spread of AIDS, and advocated for improving women's and children's health.”

She died on Dec. 27, 2002, from complications related to lung cancer. The APHA established an award in her honor and National Women’s Health Network named its leadership development program after her. Daughter JoEllen followed her mother into the medical field, earning a degree in psychology and working as an attending physician.

Toward the end of her life, Helen said, "I hope I'll see in my lifetime a growing realization that we are one world. And that no one is going to have quality of life unless we support everyone's quality of life.”

Helen Rodriguez-Trias, M.D. Photo credit: JoEllen Brainin-Rodriguez M.D., photograph by Rafael Pesquera

Sources:

American Journal of Public Health: The Face of Women’s Health: Helen Rodríguez Trías

Liberal Currents: Dr. Helen Rodríguez-Trías, The Woman who Ended Sterilization Abuse in the U.S.

National Park Service: Dr. Helen Rodríguez Trías

Massive Science: Three facts about Helen Rodríguez-Trías, pediatrician-turned-healthcare activist

NIH: Changing the Face of Medicine: Dr. Helen Rodríguez Trías, photos

Center for Puerto Rican Studies: Hidden Gems at The Archives: Dr. Helen Rodríguez-Trías

National Women’s Health Network: Helen Rodríguez-Trías, A Brief History of Reproductive Coercion

Wiki: Helen Rodríguez Trías, The Relf Sisters

Prabook: David Neumark Brainin

LinkedIn: JoEllen Brainin Rodríguez

University of Michigan Institute for Healthcare Policy and Innovation: Forced sterilization policies in the US targeted minorities and those with disabilities – and lasted into the 21st century

The Southern Poverty Law Center: Relf v. Weinberger

JSTOR: The Role of Sterilization in Controlling Puerto Rican Fertility

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